Aims: To analyse how social services relate to compulsory care legislation in applications for compulsory care for substance abuse in cases involving pregnant women, given that such commitments cannot be made solely for the sake of the fetus/unborn child.

Design: Applications for compulsory care to administrative courts involving pregnant women categorized according to how the pregnancy was presented or emphasized.

Setting: Compulsory care for substance abuse in Sweden.

Participants: 116 cases involving 107 individuals who were pregnant at the time of application for commitment to compulsory care between 2000 and 2009.

Findings: In 43% of the cases the risks for both the woman and the fetus’/child’s health was emphasized. In 28% of the cases the applications were primarily for the sake of the fetus/child. In 17% of the cases the pregnancy was mentioned in a neutral manner, while in 8% of the cases the fact that the woman was abusing substances during pregnancy was presented as an indication of the severity of the problem.

Conclusions: References were commonly made to the interests of the woman and the fetus/child as an entity, but social services also openly claimed the need for commitment primarily for the sake of the child. Arguments also mirrored the debate when legislation was first introduced; for example, that substance abuse during pregnancy is a clear indication of how serious the problem is, and how this situation may be hazardous to the woman’s mental health should she become the cause of severe and irrevocable harm to her child.

Keywords

substance abuse; pregnancy; compulsory care; decision-making in social work